The proposed project is a longitudinal follow-up study of 259 alcoholics (156 men and 103 women) consecutively admitted to two St. Louis psychiatric hospitals in 1967-68 and classified at index according to explicit criteria as primary or secondary alcoholics. The NIMH Diagnostic Interview Schedule will be used to ascertain current as well as lifetime psychiatric disorders in this population. Goals of the study are 1) to describe the long term course and outcome of alcoholism; 2) to examine specific predictors of variation in outcome (including morbidity and mortality and drinking status) according to selected social and psychiatric variables, including diagnostic subtypes of alcoholism, sex, race, family psychiatric history, early vs. late onset of alcoholism, and socio-economic status; 3) to determine whether patterns of successful long-term adjustment vary in genetically defined subtypes of alcoholics; and 4) to explore the association between diagnostic subtypes of alcoholism and long-term outcome and observe the stability of the diagnostic subroups of alcoholism over a 22-year period. This information will help inform researchers of the optimal point in time for follow-up in examination of outcome studies. It will further aid clinicians in designing and implementing needed treatment services.